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    $ wa t e r ma r k -t e xt

    $ wa t e r ma r k -t e xt

    $ wa t e r m

    a r k -t e xt

    CONDE-AGUDELO et al. Page 25

    T A B L E 1

    s i n c l u d e d

    N o o f w o m e n w

    i t h

    C L < 2 5 m m ,

    s i n g

    l e t o n g e s t a t

    i o n ,

    a n d p r e v

    i o u s

    p r e t e r m

    b i r t

    h

    g c o u n

    t r i e s

    P r i m a r y

    t a r g e t p o p u

    l a t i o n

    I n c l u s i o n

    / e x c

    l u s i o n c r

    i t e r

    i a

    I n t e r v e n t

    i o n g r o u p

    C o n

    t r o l g r o u p

    G e s

    t a t i o n a l

    a g e a t

    s c r e e n

    i n g

    ( w e e

    k s )

    I n t e r v e n

    t i o n

    C o i n t e r v e n t

    i o n s

    P r i m a r y o u

    t c o m e

    e d w

    i t h p l a c e b o

    d o m , C

    h i l e ,

    e

    W o m e n w i t h a s h o r t c e r v i x

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n o r t w i n

    p r e g n a n c y a n d a s o n o g r a p h i c c e r v i c a l l e n g t h

    1 5 .

    1 5

    2 3

    2 0 2 5

    V a g i n a l p r o g e s t e r o n e

    c a p s u l e ( 2 0 0 m g / d a y )

    o r p l a c e b o f r o m 2 4 t o

    3 3 6 / 7 w e e k s o f

    g e s t a t i o n

    N o

    S p o n t a n e o u s p r e t e r m

    b i r t h < 3 4 w e e k s

    E x c l u s i o n : m a j o r f e t a l a b n o r m a l i t i e s , p a i n f u l

    r e g u l a r u t e r i n e c o n t r a c t i o n s , a

    h i s t o r y o f

    r u p t u r e d

    m e m b r a n e s , o r c e r v i c a l c e r c l a g e .

    , S o u

    t h

    C z e c h

    hi l e

    , E l

    W o m e n w

    i t h a

    h i s t o r y o f

    s p o n t a n e o u s p r e t e r m b i r t h

    I n c l u s i o n : w o m e n w

    i t h a s i n g

    l e t o n p r e g n a n c y ,

    1 8 4 5 y e a r s o f a g e , a n d a h i s t o r y o f

    s p o n t a n e o u s s i n g l e t o n p r e t e r m b i r t h a t b e t w e e n

    2 0 a n d 3 5 w e e k s o f g e s t a t i o n i n t h e

    i m m e d i a t e l y p r e c e d i n g p r e g n a n c y .

    9

    1 3

    1 6 2

    2

    V a g

    i n a l p r o g e s

    t e r o n e

    g e l ( 9 0 m g / d a y ) o r

    p l a c e b o f r o m 1 8 2 2 t o

    3 7 0 / 7 w e e k s o f

    g e s t a t i o n , r u p t u r e o f

    m e m b r a n e s o r p r e t e r m

    d e l i v e r y , w

    h i c h e v e r

    o c c u r r e d f i r s t .

    N o

    P r e t e r m

    b i r t h

    < 3 2

    w e e k s

    E x c l u s i o n : p l a n n e d c e r v i c a l c e r c l a g e , h

    i s t o r y

    o f a d v e r s e r e a c t i o n t o p r o g e s t e r o n e , t r e a t m e n t

    w i t h p r o g e s t e r o n e w i t h i n 4 w e e k s b e f o r e

    e n r o l l m e n t , t r e a t m e n t f o r a s e i z u r e d i s o r d e r , a

    p s y c h i a t r i c i l l n e s s o r c h r o n i c h y p e r t e n s i o n a t

    t h e t i m e o f e n r o l m e n t , h i s t o r y o f a c u t e o r

    c h r o n i c c o n g e s

    t i v e

    h e a r

    t f a i

    l u r e , r e n a l

    f a i l u r e ,

    u n c o n t r o l l e d d i a b e t e s m e l l i t u s , a c t i v e l i v e r

    d i s o r d e r , H I V i n f e c t i o n w i t h a C D 4 c o u n t o f

    < 3 5 0 c e l l s / m m

    3 a n d r e q u i r i n g m u l t i p l e

    a n t i v i r a l a g e n t s , p l a c e n t a p r e v i a

    , h i s t o r y o r

    s u s p i c i o n o f b r e a s t o r g e n i t a l t r a c t m a l i g n a n c y ,

    h i s t o r y o r s u s p i c i o n o f t h r o m b o e m b o l i c

    d i s e a s e , M l l e r i a n d u c t a n o m a l y , m a j o r f e t a l

    a n o m a l y o r c h r o m o s o m a l d i s o r d e r , o

    r

    m u l t i f e t a l g e s t a t i o n .

    W o m e n a t h i g h r i s k o f p r e t e r m

    b i r t h

    I n c l u s i o n : w o m e n w i t h a l e a s t o n e p r e v i o u s

    s p o n t a n e o u s p r e t e r m b i r t h , u

    t e r i n e

    m a l f o r m a t i o n o r t w i n p r e g n a n c y .

    3

    3

    2 0 2 4

    V a g i n a l p r o g e s t e r o n e

    s u p p o s i t o r y ( 1 0 0 m g /

    d a y ) o r p l a c e b o f r o m

    2 4 t o 3 4 w e e k s o f

    g e s t a t i o n .

    N o

    P r e t e r m b i r t h < 3 7

    w e e k s

    E x c l u s i o n : i n - p l a c e o r p l a n n e

    d c e r v

    i c a l

    c e r c l a g e

    , o r s e r i o u s f e t a l a n o m a l i e s

    , R e p u b

    l i c o f

    le , C

    z e c h

    d i a , I s r a e l ,

    W o m e n w

    i t h a s h o r

    t c e r v i x

    I n c l u s i o n : w o m e n w

    i t h a s i n g

    l e t o n p r e g n a n c y ,

    t r a n s v a g i n a l s o n o g r a p h i c c e r v i c a l l e n g t h

    4 8

    4 4

    1 9 2

    3

    V a g

    i n a l p r o g e s

    t e r o n e

    g e l ( 9 0 m g / d a y ) o r

    p l a c e b o f r o m 2 0 2 3 t o

    E m e r g e n c y c e r v

    i c a l

    c e r c l a g e ( 4 i n v a g i n a l

    p r o g e s t e r o n e g r o u p

    P r e t e r m

    b i r t h

    < 3 3

    w e e k s

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    $ wa t e r ma r k -t e xt

    $ wa t e r ma r k -t e xt

    $ wa t e r m

    a r k -t e xt

    CONDE-AGUDELO et al. Page 26

    N o o f w o m e n w

    i t h

    C L < 2 5 m m ,

    s i n g

    l e t o n g e s t a t

    i o n ,

    a n d p r e v

    i o u s

    p r e t e r m

    b i r t

    h

    g c o u n

    t r i e s

    P r i m a r y

    t a r g e t p o p u

    l a t i o n

    I n c l u s i o n

    / e x c

    l u s i o n c r

    i t e r

    i a

    I n t e r v e n t

    i o n g r o u p

    C o n

    t r o l g r o u p

    G e s

    t a t i o n a l

    a g e a t

    s c r e e n

    i n g

    ( w e e

    k s )

    I n t e r v e n

    t i o n

    C o i n t e r v e n t

    i o n s

    P r i m a r y o u

    t c o m e

    S o u t h A f r i c a ,

    b e t w e e n

    1 0 a n d 2 0 m m , a n d w i t h o u t s i g n s o r

    s y m p t o m s o f p r e t e r m l a b o r .

    3 6 6 / 7 w e e k s o f

    g e s t a t i o n , r u p t u r e o f

    m e m b r a n e s o r p r e t e r m

    d e l i v e r y , w h i c h e v e r

    o c c u r r e d f i r s t .

    [ 8 . 3

    % ] a n d 1 [ 2

    . 3 % ] i n

    p l a c e b o g r o u p )

    E x c l u s i o n : p l a n n e d c e r c l a g e , a c u t e c e r v i c a l

    d i l a t i o n

    , a l l e r g i c r e a c t i o n t o p r o g e s t e r o n e ,

    c u r r e n t o r r e c e n t p r o g e s

    t o g e n

    t r e a t m e n

    t w i t h i n

    t h e p r e v i o u s f o u r w e e k s

    , c h r o n i c m e d i c a l

    c o n d i t i o n s t h a t w o u l d i n t e r f e r e w i t h s t u d y

    p a r t i c i p a t

    i o n o r e v a l u a

    t i o n o f

    t h e

    t r e a t m e n

    t ,

    m a j o r f e t a l a n o m a l y o r k n o w n c h r o m o s o m a l

    a b n o r m a l i t y

    , u t e r i n e a n a t o m i c m a l f o r m a t i o n ,

    v a g i n a l

    b l e e

    d i n g , o r k n o w n o r s u s p e c

    t e d

    c l i n i c a l c h o r i o a m n i o n i t i s .

    e r c l a g e

    W o m e n w i t h a s h o r t c e r v i x

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n o r m u l t i p l e

    g e s t a t i o n a n d t r a n s v a g i n a l s o n o g r a p h i c d i l a t i o n

    o f t h e i n t e r n a l o s w i t h e i t h e r m e m b r a n e

    p r o l a p s e i n t o t h e e n d o c e r v i c a l c a n a l a t l e a s t

    2 5 % o f t h e t o t a l c e r v i c a l l e n g t h b u t n o t b e y o n d

    t h e e x t e r n a l o s o r a c e r v i c a l l e n g t h < 2 5 m m .

    5 3

    4 9

    1 6 2 4

    M c D o n a l d p r o c e d u r e

    w i t h a s i n g l e s t i t c h o f

    p e r m a n e n t

    m o n o f i l a m e n t o r n o

    c e r c l a g e

    C l i n d a m y c i n a n d

    i n d o m e t a c i n w h i c h w e r e

    d i s c o n t i n u e d a t

    a p p r o x i m a t e l y 2 4 h o u r s

    a f t e r r a n d o m i z a t i o n

    ( b o t h g r o u p s ) . R e s c u e

    c e r c l a g e ( b o t h g r o u p s )

    G e s t a t i o n a l a g e a t

    d e l i v e r y a n d n e o n a t a l

    m o r b i d i t y

    E x c l u s i o n : m e m b r a n e p r o l a p s e b e y o n d t h e

    e x t e r n a l o s , a n y f e t a l l e t h a l c o n g e n i t a l o r

    c h r o m o s o m a l a n o m a l y , a b r u p t i o n p l a c e n t a

    ,

    u n e x p l a i n e d v a g i n a l b l e e d i n g ,

    c h o r i o a m n i o n i t i s , p e r s i s t e n t u t e r i n e a c t i v i t y

    w i t h c e r v i c a l c h a n g e , o r a n y o t h e r

    c o n t r a i n d i c a t i o n t o a c e r c l a g e p r o c e d u r e .

    n d s

    W o m e n w i t h a s h o r t c e r v i x

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n g e s t a t i o n ,

    r i s k f a c t o r s a n d / o r s y m p t o m s o f c e r v i c a l

    i n c o m p e t e n c e , a n d a c e r v i c a l l e n g t h < 2 5 m m .

    1 4

    1 2

    1 4 2 3

    M c D o n a l d p r o c e d u r e

    w i t h b r a i d e d p o l y e s t e r

    t h r e a d o r n o c e r c l a g e

    A m o x i c i l l i n / c l a v u l a n i c

    a c i d f o r 7 d a y s a n d b e d

    r e s t ( b o t h g r o u p s ) ; t w o

    1 0 0 m g s u p p o s i t o r i e s o f

    i n d o m e t h a c i n ( c e r c l a g e

    g r o u p ) . R

    e s c u e c e r c l a g e

    ( n o c e r c l a g e g r o u p )

    P r e t e r m b i r t h < 3 4

    w e e k s

    , a n d n e o n a t a l

    m o r b i d i t y a n d

    m o r t a l i t y

    E x c l u s i o n : f e t a l c o n g e n i t a l / c h r o m o s o m a l

    a n o m a l i e s , p r e t e r m r u p t u r e o f m e m b r a n e s ,

    m e m

    b r a n e s

    b u l g i n g

    i n t o t h e v a g i n a , o r

    i n t r a u t e r i n e i n f e c t i o n .

    d o m , B r a z i l ,

    S l o v e n i a ,

    le

    W o m e n w i t h a s h o r t c e r v i x

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n g e s t a t i o n

    a n d c e r v i c a l l e n g t h 1 5 m m .

    2 1

    2 3

    2 2 2 4

    S h i r o d k a r s u t u r e w i t h

    m e r s i l e n e t a p e o r n o

    c e r c l a g e

    P r o p h y l a c t i c

    c o r t i c o s t e r o i d s f o r f e t a l

    l u n g m a t u r a t i o n ( b o t h

    g r o u p s

    ) ; s i n g

    l e d o s e o

    f

    e r y t h r o m y c i n ( c e r c l a g e

    g r o u p )

    P r e t e r m b i r t h < 3 3

    w e e k s

    E x c l u s i o n : m a j o r

    f e t a l a b n o r m a l

    i t i e s , p a i n f u l

    r e g u l a r u t e r i n e c o n t r a c t i o n s , h

    i s t o r y o f

    r u p t u r e d

    m e m

    b r a n e s a n

    d c e r v

    i c a l c e r c

    l a g e

    i n

    s i t u

    , a n d

    d i l a t e d c e r v

    i x d u r i n g

    t r a n s v a g i n a

    l

    s o n o g r a p h y .

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    $ wa t e r ma r k -t e xt

    $ wa t e r ma r k -t e xt

    $ wa t e r m

    a r k -t e xt

    CONDE-AGUDELO et al. Page 27

    N o o f w o m e n w

    i t h

    C L < 2 5 m m ,

    s i n g

    l e t o n g e s t a t

    i o n ,

    a n d p r e v

    i o u s

    p r e t e r m

    b i r t

    h

    g c o u n

    t r i e s

    P r i m a r y

    t a r g e t p o p u

    l a t i o n

    I n c l u s i o n

    / e x c

    l u s i o n c r

    i t e r

    i a

    I n t e r v e n t

    i o n g r o u p

    C o n

    t r o l g r o u p

    G e s

    t a t i o n a l

    a g e a t

    s c r e e n

    i n g

    ( w e e

    k s )

    I n t e r v e n

    t i o n

    C o i n t e r v e n t

    i o n s

    P r i m a r y o u

    t c o m e

    W o m e n w i t h a s h o r t c e r v i x

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n o r t w i n

    g e s t a t i o n a n

    d c e r v

    i c a l

    l e n g

    t h < 2 5 m m o r

    s i g n i f i c a n t f u n n e l i n g ( > 2 5 % ) .

    1 4

    1 7

    1 4 2 3

    M c D o n a l d p r o c e d u r e

    w i t h m e r s i

    l e n e

    t a p e o r

    n o c e r c l a g e

    B e d r e s t ( b o t h g r o u p s )

    P r e t e r m b i r t h < 3 5

    w e e

    k s

    E x c l u s i o n : h i s t o r y - i n d i c a t e d p r o p h y l a c t i c

    c e r c l a g e

    , l a s t p r e g n a n c y d e l i v e r e d a t t e r m ,

    m a j o r f e t a l a n o m a l y , t r i p l e t s o r h i g h e r o r d e r

    p r e g n a n c y , p

    r e v i o u s i n c l u s i o n i n a n o t h e r t r i a l ,

    c u r r e n t d r u g a b u s e , o r r e g u l a r c o n t r a c t i o n s

    l e a d i n g t o p r e t e r m l a b o r a f t e r i d e n t i f i c a t i o n o f

    a b n o r m a l c e r v i x b y u l t r a s o n o g r a p h y

    .

    W o m e n w i t h a s h o r t c e r v i x ,

    s i n g l e t o n g e s t a t i o n , a n d p r i o r

    s p o n t a n e o u s p r e t e r m b i r t h

    I n c l u s i o n : w o m e n w i t h a s i n g l e t o n g e s t a t i o n , a t

    l e a s t 1 p r i o r s p o n t a n e o u s p r e t e r m b i r t h

    b e t w e e n

    1 7 a n d 3 3 w e e k s o f g e s t a t i o n , a n d

    m i d t r i m e s

    t e r c e r v i c a

    l l e n g t

    h < 2 5 m m .

    1 4 8

    1 5 3

    1 6 2 2

    M c D o n a l d p r o c e d u r e

    w i t h n o n a b s o r b a b l e

    s u t u r e ( b r a i d e d t a p e ) o r

    n o c e r c

    l a g e

    1 7 - h y d r o x y p r o g e s t e r

    o n e c a p r o a t e ( 4 7

    [ 3 1 . 8 % ] i n c e r c l a g e

    g r o u p a n

    d 5 2 [ 3 4 . 0 ] i n

    n o c e r c l a g e g r o u p ) ;

    v a g i n a l p r o g e s t e r o n e ( 1

    [ 0 . 7

    % ] i n n o c e r c l a g e

    g r o u p ) . R e s c u e c e r c l a g e

    ( n o c e r c l a g e g r o u p )

    P r e t e r m b i r t h < 3 5

    w e e k s

    E x c l u s i o n : f e t a l a n o m a l y , p l a n n e d h i s t o r y -

    i n d i c a t e d c e r c l a g e f o r a c l i n i c a l d i a g n o s i s o f

    c e r v i c a l i n s u f f i c i e n c y , a n d c l i n i c a l l y

    s i g n i f i c a n t m a t e r n a l / f e t a l c o m p l i c a t i o n s ( e g ,

    f e t a l r e d c e

    l l i s o i m m u n

    i z a t

    i o n ,

    t r e a t e d c h r o n i c

    h y p e r t e n s i o n , i n s u l i n - d e p e n d e n t d i a b e t e s ) a n d

    c e r v i c a l i n s u f f i c i e n c y - i n d i c a t e d c e r c l a g e i n a

    p r i o r p r e g n a n c y .

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    T A B L E 2

    a r i s o n s

    D i r e c

    t c o m p a r i s o n s

    I n d i r e c t c o m p a r i s o n

    V a g

    i n a l p r o g e s

    t e r o n e v e r s u s p l a c e b o

    C e r c l a g e v e r s u s n o c e r c l a g e

    V a g

    i n a l p r o g e s

    t e r o n e v e r s u s

    c e r c

    l a g e

    N o . o f

    t r i a l s

    I n t e r v e n

    t i o n n /

    N ( % )

    C o n t r o l n /

    N ( % )

    R R ( 9 5 %

    C I )

    I 2 ( % )

    N o . o

    f t r i a l s

    I n t e r v e n

    t i o n n /

    N ( % )

    C o n

    t r o l n /

    N ( % )

    R R ( 9 5 %

    C I )

    P v a

    l u e a

    R R ( 9 5 %

    C I )

    P v a

    l u e b

    4

    9 / 7 5 ( 1 2 . 0 )

    2 4 / 8 3 ( 2 8 . 9 )

    0 . 4 7 ( 0

    . 2 4 0 . 9 1 )

    0

    5

    4 8 / 2 5 0 ( 1 9 . 2 )

    7 5 / 2 5 4 ( 2 9 . 5 )

    0 . 6 6 ( 0

    . 4 8 0 . 9 1 )

    > . 1

    0

    0 . 7 1 ( 0 . 3 4 1 . 4 9 )

    0 . 8 8

    ity / m o r t a l i t y

    c

    4

    7 / 7 5 ( 9

    . 3 )

    2 0 / 8 3 ( 2 4 . 1 )

    0 . 4 3 ( 0

    . 2 0 0 . 9 4 )

    0

    5

    3 9 / 2 5 0 ( 1 5 . 6 )

    6 3 / 2 5 4 ( 2 4 . 8 )

    0 . 6 4 ( 0

    . 4 5 0 . 9 1 )

    > . 1

    0

    0 . 6 7 ( 0 . 2 9 1 . 5 7 )

    0 . 8 6

    4

    3 4 / 7 5 ( 4 5 . 3 )

    4 6 / 8 3 ( 5 5 . 4 )

    0 . 8 4 ( 0

    . 6 1 1 . 1 4 )

    0

    5

    1 0 5 / 2 5 0 ( 4 2 . 0 )

    1 5 4 / 2 5 4 ( 6 0

    . 6 )

    0 . 7 0 ( 0

    . 5 8 0 . 8 3 )

    > . 1

    0

    1 . 2 0 ( 0 . 8 4 1 . 7 2 )

    0 . 9 4

    4

    2 0 / 7 5 ( 2 6 . 7 )

    3 5 / 8 3 ( 4 2 . 2 )

    0 . 6 6 ( 0

    . 4 2 1 . 0 4 )

    0

    5

    7 1 / 2 5 0 ( 2 8 . 4 )

    1 0 5 / 2 5 4 ( 4 1

    . 3 )

    0 . 7 0 ( 0

    . 5 5 0 . 8 9 )

    > . 1

    0

    0 . 9 4 ( 0 . 5 6 1 . 5 8 )

    0 . 9 8

    4

    6 / 7 5 ( 8

    . 0 )

    1 4 / 8 3 ( 1 6 . 9 )

    0 . 5 1 ( 0

    . 2 2 1 . 1 8 )

    0

    5

    3 2 / 2 5 0 ( 1 2 . 8 )

    5 1 / 2 5 4 ( 2 0 . 1 )

    0 . 6 4 ( 0

    . 4 3 0 . 9 6 )

    > . 1

    0

    0 . 8 0 ( 0 . 3 1 2 . 0 2 )

    0 . 9 2

    e

    4

    3 / 7 5 ( 4

    . 0 )

    1 2 / 8 3 ( 1 4 . 5 )

    0 . 3 8 ( 0

    . 1 3 1 . 0 7 )

    7

    4

    1 3 / 2 0 7 ( 6

    . 3 )

    2 1 / 1 9 6 ( 1 0 . 7 )

    0 . 6 1 ( 0

    . 3 2 1 . 1 9 )

    > . 1

    0

    0 . 6 2 ( 0 . 1 8 2 . 1 6 )

    0 . 8 4

    h e m o r r h a g e

    4

    1 / 7 5 ( 1

    . 3 )

    3 / 8 3

    ( 3 . 6

    )

    0 . 5 0 ( 0

    . 0 8 2 . 9 6 )

    8

    4

    0 / 2 0 7 ( 0

    . 0 )

    4 / 1 9 6 ( 2

    . 0 )

    0 . 2 8 ( 0

    . 0 5 1 . 6 4 )

    > . 1

    0

    1 . 7 9 ( 0 . 1 5 2 2

    . 0 0 )

    0 . 8 0

    4

    0 / 7 5 ( 0

    . 0 )

    1 / 8 3

    ( 1 . 2

    )

    0 . 4 7 ( 0

    . 0 2 1 0

    . 3 2 )

    0

    4

    1 / 2 0 7 ( 0

    . 5 )

    2 / 1 9 6 ( 1

    . 0 )

    0 . 6 2 ( 0

    . 0 8 4 . 6 7 )

    > . 1

    0

    0 . 7 6 ( 0 . 0 2 3 1

    . 4 9 )

    0 . 9 0

    4

    0 / 7 5 ( 0

    . 0 )

    6 / 8 3

    ( 7 . 2

    )

    0 . 2 5 ( 0

    . 0 5 1 . 3 7 )

    0

    4

    8 / 2 0 7 ( 3

    . 9 )

    1 7 / 1 9 6 ( 8 . 7 )

    0 . 4 7 ( 0

    . 2 1 1 . 0 5 )

    > . 1

    0

    0 . 5 3 ( 0 . 0 8 3 . 3 5 )

    0 . 7 8

    2

    0 / 5 1 ( 0

    . 0 )

    1 / 4 7

    ( 2 . 1

    )

    0 . 3 1 ( 0

    . 0 1 7 . 3 2 )

    0

    1

    7 / 1 3 5 ( 5

    . 2 )

    6 / 1 2 7 ( 4

    . 7 )

    1 . 1 0 ( 0

    . 3 8 3 . 1 8 )

    > . 1 0

    0 . 2 8 ( 0 . 0 1 9 . 0 1 )

    0 . 5 8

    ty d

    4

    3 / 7 5 ( 4

    . 0 )

    1 6 / 8 3 ( 1 9 . 3 )

    0 . 2 9 ( 0

    . 1 1 0 . 8 1 )

    0

    4

    1 7 / 2 0 7 ( 8

    . 2 )

    2 8 / 1 9 6 ( 1 4 . 3 )

    0 . 6 0 ( 0

    . 3 4 1 . 0 6 )

    > . 1 0

    0 . 4 8 ( 0 . 1 5 1 . 5 3 )

    0 . 7 5

    4

    5 / 7 5 ( 6

    . 7 )

    7 / 8 3

    ( 8 . 4

    )

    0 . 7 3 ( 0

    . 2 5 2 . 1 0 )

    0

    5

    2 2 / 2 5 0 ( 8

    . 8 )

    3 5 / 2 5 4 ( 1 3 . 8 )

    0 . 6 5 ( 0

    . 4 0 1 . 0 7 )

    > . 1 0

    1 . 1 2 ( 0 . 3 5 3 . 6 3 )

    0 . 9 6

    4

    1 1 / 7 5 ( 1 4 . 7 )

    3 3 / 8 3 ( 3 9 . 8 )

    0 . 3 9 ( 0

    . 2 1 0 . 7 1 )

    0

    4

    5 7 / 2 0 7 ( 2 7 . 5 )

    6 7 / 1 9 6 ( 3 4 . 2 )

    0 . 6 3 ( 0

    . 3 4 1 . 1 8 )

    < . 1

    0

    0 . 6 2 ( 0 . 2 6 1 . 4 8 )

    0 . 8 4

    4

    3 0 / 7 5 ( 4 0 . 0 )

    4 2 / 8 3 ( 5 0 . 6 )

    0 . 7 9 ( 0

    . 5 5 1 . 1 3 )

    0

    5

    8 6 / 2 5 0 ( 3 4 . 4 )

    1 1 7 / 2 4 9 ( 4 7

    . 0 )

    0 . 6 5 ( 0

    . 4 2 1 . 0 0 )

    < . 1

    0

    1 . 2 2 ( 0 . 6 9 2 . 1 4 )

    0 . 9 3

    4

    8 / 7 5 ( 1 0 . 7 )

    1 8 / 8 3 ( 2 1 . 7 )

    0 . 5 3 ( 0

    . 2 6 1 . 1 1 )

    0

    5

    4 2 / 2 5 0 ( 1 6 . 8 )

    6 6 / 2 4 9 ( 2 6 . 5 )

    0 . 6 4 ( 0

    . 4 5 0 . 9 0 )

    > . 1 0

    0 . 8 3 ( 0 . 3 7 1 . 8 5 )

    0 . 9 3

    e o n a t a l i n t e n s i v e c a r e u n i t ; R R , r e l a t i v e r i s k

    Q s t a t i s t i c s ( t e s t o f h e t e r o g e n e i t y )

    in g e v e n t s : r e s p i r a t o r y d i s t r e s s s y n d r o m e , g r a d e I I I / I V i n t r a v e n t r i c u l a r h e m o r r h a g e , n e c r o t i z i n g e n t e r o c o l i t i s

    , n e o n a t a l s e p s i s

    , b r o n c h o p u l m o n a r y d y s p l a s i a , o r p e r i n a t a l d e a t h

    in g e v e n t s : r e s p i r a t o r y d i s t r e s s s y n d r o m e , g r a d e I I I / I V i n t r a v e n t r i c u l a r h e m o r r h a g e , n e c r o t i z i n g e n t e r o c o l i t i s

    , n e o n a t a l s e p s i s , o r b r o n c h o p u l m o n a r y d y s p l a s i a

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    T A B L E 3

    S e n s i t i v i t y a n a l y s i s b y e x c l u d i n g w o m e n w h o r e c e i v e d p r o g e s t e r o n e i n t r i a l s e v a l u a t i n g c e r c l a g e a n d p a t i e n t s w h o u n d e r w e n t a c e r c l a g e i n t r i a l s

    e v a l u a t i n g v a g i n a l p r o g e s t e r o n e

    D i r e c

    t c o m p a r i s o n s

    I n d i r e c t c o m p a r i s o n

    V a g

    i n a l p r o g e s

    t e r o n e v e r s u s p

    l a c e

    b o

    C e r c l a g e v e r s u s n o c e r c

    l a g e

    V a g

    i n a l p r o g e s

    t e r o n e v e r s u s c e r c

    l a g e

    O u t c o m e

    I n t e r v e n

    t i o n n /

    N ( % )

    C o n

    t r o l n /

    N ( % )

    R R ( 9 5 %

    C I )

    I n t e r v e n

    t i o n

    C o n

    t r o l

    n / N ( % )

    C o n

    t r o l n /

    N ( % )

    R R ( 9 5 %

    C I )

    R R ( 9 5 %

    C I )

    P v a

    l u e a

    P r e t e r m b i r t h < 3 2 w e e k s

    8 / 7 1 ( 1 1 . 3 )

    2 4 / 8 2 ( 2 9 . 3 )

    0 . 4 4 ( 0

    . 2 2 0 . 8 7 )

    4 0 / 2 0 3 ( 1 9 . 7 )

    6 4 / 2 0 1 ( 3 1 . 8 )

    0 . 6 3 ( 0

    . 4 5 0 . 8 8 )

    0 . 7 0 ( 0

    . 3 3 1 . 5 0 )

    0 . 8 8

    P r e t e r m b i r t h < 2 8 w e e k s

    5 / 7 1 ( 7

    . 0 )

    1 4 / 8 2 ( 1 7 . 1 )

    0 . 4 6 ( 0

    . 1 9 1 . 1 1 )

    2 8 / 2 0 3 ( 1 3 . 8 )

    4 3 / 2 0 1 ( 2 1 . 4 )

    0 . 6 5 ( 0

    . 4 3 1 . 0 0 )

    0 . 7 1 ( 0

    . 2 7 1 . 8 8 )

    0 . 8 8

    P r e t e r m

    b i r t h

    < 3 5 w e e k s

    1 7 / 7 1 ( 2 3 . 9 )

    3 5 / 8 2 ( 4 2 . 7 )

    0 . 5 9 ( 0

    . 3 7 0 . 9 5 )

    5 7 / 2 0 3 ( 2 8 . 1 )

    8 5 / 2 0 1 ( 4 2 . 3 )

    0 . 6 7 ( 0

    . 5 1 0 . 8 8 )

    0 . 8 8 ( 0

    . 5 1 1 . 5 2 )

    0 . 9 6

    P r e t e r m b i r t h < 3 7 w e e k s

    3 1 / 7 1 ( 4 3 . 7 )

    4 6 / 8 2 ( 5 6 . 1 )

    0 . 8 0 ( 0

    . 5 8 1 . 1 0 )

    8 2 / 2 0 3 ( 4 0 . 4 )

    1 2 3 / 2 0 1 ( 6 1 . 2 )

    0 . 6 7 ( 0

    . 5 5 0 . 8 2 )

    1 . 1 9 ( 0

    . 8 2 1 . 7 4 )

    0 . 9 4

    P e r i n a t a l m o r t a l i t y

    4 / 7 1 ( 5

    . 6 )

    7 / 8 2 ( 8

    . 5 )

    0 . 6 1 ( 0

    . 2 0 1 . 9 1 )

    1 9 / 2 0 3 ( 9

    . 4 )

    3 3 / 2 0 1 ( 1 6 . 4 )

    0 . 5 8 ( 0

    . 3 5 0 . 9 8 )

    1 . 0 5 ( 0

    . 3 0 3 . 6 4 )

    0 . 9 8

    C I , c o n f i d e n c e i n t e r v a l ; R R , r e l a t i v e r i s k

    a P v a l u e f o r t h e t e s t o f a s s o c i a t i o n

    Am J Obstet Gynecol . Author manuscript; available in PMC 2013 January 01.